Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate t...Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation （SinoSCORE）. Methods Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve （AUC） was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow （H-L） goodness-of-fit test was used to study the calibration of the predictive models. Results A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% （additive）, 3.19% （logistic） and 3.66% （SinoSCORE）. AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good （H-L： P=-0.250 and P=0.051, respectively）, but the logistic EuroSCORE model had a poor calibration （H-L： P〈0.05）. The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients, However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles. Conclusions The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.展开更多
Objective To validate of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in Cantonese surgery patients. Methods Data from Guangdong Cardiovascular Institute in the period January 2004 through Dece...Objective To validate of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in Cantonese surgery patients. Methods Data from Guangdong Cardiovascular Institute in the period January 2004 through December 2008 were analyzed on 2462 Cantonese heart surgery patients. First,compared risk factors of this series and database of SinoSCORE,and then calculated展开更多
目的采用心脏手术风险评估欧洲系统（European System for Cardiac Operative Risk Evaluation，EuroSCORE）评估高手术风险冠状动脉旁路移植术（CABG）患者的早期临床结果。方法将2004年2～9月在我科行CABG的84例患者按EuroSCORE评分...目的采用心脏手术风险评估欧洲系统（European System for Cardiac Operative Risk Evaluation，EuroSCORE）评估高手术风险冠状动脉旁路移植术（CABG）患者的早期临床结果。方法将2004年2～9月在我科行CABG的84例患者按EuroSCORE评分分为高手术风险组（≥6,40例）和中低手术风险组（0～5,44例）；记录两组手术方案、术后并发症发生情况；在手术后应用急性生理学和慢性健康状况评分Ⅲ（APACHEⅢ）和序贯器官衰竭评估（SOFA）对患者进行危重症评估。分析比较两组患者早期临床结果。结果高手术风险组的手术死亡率、需长时间重症监护治疗比率、术后并发症发生率和危重程度均高于中低手术风险组。在总体水平上A0，A1，Amax和S1，Smax均与standard EuroSCORE（P〈0．01）和logistic EuroSCORE（P〈0．05）分别呈正相关；在不同风险度比较时，仅在高手术风险组中standard EuroSCORE与A1，Anax，S1和Smax呈正相关（P〈0．05）；logistic EuroSCORE仅与Amax相关（P〈0．05）。结论EuroSCORE系统在总体上能够很好地评估心脏手术风险，对高危患者更敏感。术前准确对患者状况进行评估，术中完善心肌保护、有效的心肌供血重建和彻底心内畸形矫正，术后及时正确的处理可以改善高手术风险患者的预后。展开更多
随着心脏手术例数的增加和社会老龄化的加剧,手术风险相应增高。故心脏手术前评估病情程度,对于正确选择治疗方式和时机,提高疗效,合理配置医疗资源和改善医患沟通具有重要意义。中国冠状动脉旁路移植手术风险评估系统(Sino System for ...随着心脏手术例数的增加和社会老龄化的加剧,手术风险相应增高。故心脏手术前评估病情程度,对于正确选择治疗方式和时机,提高疗效,合理配置医疗资源和改善医患沟通具有重要意义。中国冠状动脉旁路移植手术风险评估系统(Sino System for Coronary Operation Risk Evalution,Sino SCORE)是我国首个心脏手术风险评估系统,已广泛应用于临床。文中就Sino SCORE的来源、构成、临床应用等作一简介。展开更多
目的评价欧洲心脏手术风险评估系统(European System for Cardiac Operative Risk Evaluation,EuroSCORE)预测实施心脏瓣膜手术的维吾尔族与汉族患者在院死亡率的准确性。方法分析2012年9月至2013年12月于新疆医科大学第一附属医院因心...目的评价欧洲心脏手术风险评估系统(European System for Cardiac Operative Risk Evaluation,EuroSCORE)预测实施心脏瓣膜手术的维吾尔族与汉族患者在院死亡率的准确性。方法分析2012年9月至2013年12月于新疆医科大学第一附属医院因心脏瓣膜疾病行外科治疗的361例患者的临床资料,维吾尔族患者209例,汉族患者152例。先按additive及logisticEuroSCORE两种方法评分,将患者分为低风险、中风险、高风险3个亚组,比较全组及各亚组患者的实际与预测死亡率。模型预测的校准度采用拟合优度检验,预测的鉴别度采用受试者工作特征(ROC)曲线下面积检验。结果全组患者实际在院死亡率为8.03%,维吾尔族患者6.70%,汉族患者9.87%。additiveEuroSCORE与logisticEuroSCORE预测维吾尔族患者在院死亡率分别为4.03%和3.37%,汉族患者为4.43%和3.77%,均低于实际死亡率(P<0.01)。全组患者additiveEuroSCORE与logisticEuroSCORE的曲线下面积分别为0.606和0.598,汉族患者分别为0.574和0.553,维吾尔族患者分别为0.609和0.610。结论 EuroSCORE模型对本地区维吾尔族与汉族瓣膜病患者的死亡风险预测准确性较差,不适合心脏瓣膜手术的风险预测,临床应用时需谨慎考虑。展开更多
欧洲心脏手术风险评估系统(European system for cardiac operative risk evaluation,EuroSCORE)是应用广泛并具有影响力的心脏外科风险评估系统之一。最初用于预测心脏手术后死亡概率的量化评分,之后应用范围发展到预测中长期死亡率和...欧洲心脏手术风险评估系统(European system for cardiac operative risk evaluation,EuroSCORE)是应用广泛并具有影响力的心脏外科风险评估系统之一。最初用于预测心脏手术后死亡概率的量化评分,之后应用范围发展到预测中长期死亡率和生存率、术后ICU滞留时间、治疗费用和重要并发症等方面。EuroSCOREⅡ是最新版本,其在预测手术死亡率、术后长期生存率等方面比旧版本更加准确,但也存在预测终点范围有限、低估重危患者死亡率、术前危险因素不够全面等不足。本文简述EuroSCORE的产生、发展以及临床应用情况。展开更多
文摘Background The European System for Cardiac Operative Risk Evaluation （EuroSCORE） is one of the most widely used risk models for the predicting mortality after cardiac surgery. The aim of this study was to validate the EuroSCORE model for predicting operative mortality in heart valve surgery on a Chinese multicenter database and comparing the performance of EuroSCORE with our new risk stratification system, the Sino System for Coronary Operative Risk Evaluation （SinoSCORE）. Methods Data from patients undergoing heart valve surgery between January 2007 and December 2008 were retrospectively collected, from 43 hospitals in China. The EuroSCORE and the SinoSCORE were calculated for each patient. Mortality was defined as any in-hospital death. Area under the receiver operating characteristics curve （AUC） was used to study the discriminatory abilities of the models. The Hosmer-Lemeshow （H-L） goodness-of-fit test was used to study the calibration of the predictive models. Results A total of 15 367 patients were analyzed. For the entire cohort, the observed mortality was 2.34%, the predicted mortality was 3.71% （additive）, 3.19% （logistic） and 3.66% （SinoSCORE）. AUC was 0.747 for SinoSCORE, 0.699 additive and 0.696 for logistic EuroSCORE. Calibration of SinoSCORE and additive EuroSCORE was good （H-L： P=-0.250 and P=0.051, respectively）, but the logistic EuroSCORE model had a poor calibration （H-L： P〈0.05）. The discriminatory ability and calibration of the SinoSCORE were good in low- and high-risk patients, However, the discriminatory ability of the EuroSCORE model was poor in all risk deciles. Conclusions The EuroSCORE does not accurately predict mortality in Chinese patients with heart valve surgery, and the SinoSCORE is superior to the EuroSCORE at predicting in-hospital mortality in Chinese heart valve surgery patients.
文摘Objective To validate of the Chinese system for cardiac operative risk evaluation (SinoSCORE) in Cantonese surgery patients. Methods Data from Guangdong Cardiovascular Institute in the period January 2004 through December 2008 were analyzed on 2462 Cantonese heart surgery patients. First,compared risk factors of this series and database of SinoSCORE,and then calculated
文摘随着心脏手术例数的增加和社会老龄化的加剧,手术风险相应增高。故心脏手术前评估病情程度,对于正确选择治疗方式和时机,提高疗效,合理配置医疗资源和改善医患沟通具有重要意义。中国冠状动脉旁路移植手术风险评估系统(Sino System for Coronary Operation Risk Evalution,Sino SCORE)是我国首个心脏手术风险评估系统,已广泛应用于临床。文中就Sino SCORE的来源、构成、临床应用等作一简介。
文摘目的评价欧洲心脏手术风险评估系统(European System for Cardiac Operative Risk Evaluation,EuroSCORE)预测实施心脏瓣膜手术的维吾尔族与汉族患者在院死亡率的准确性。方法分析2012年9月至2013年12月于新疆医科大学第一附属医院因心脏瓣膜疾病行外科治疗的361例患者的临床资料,维吾尔族患者209例,汉族患者152例。先按additive及logisticEuroSCORE两种方法评分,将患者分为低风险、中风险、高风险3个亚组,比较全组及各亚组患者的实际与预测死亡率。模型预测的校准度采用拟合优度检验,预测的鉴别度采用受试者工作特征(ROC)曲线下面积检验。结果全组患者实际在院死亡率为8.03%,维吾尔族患者6.70%,汉族患者9.87%。additiveEuroSCORE与logisticEuroSCORE预测维吾尔族患者在院死亡率分别为4.03%和3.37%,汉族患者为4.43%和3.77%,均低于实际死亡率(P<0.01)。全组患者additiveEuroSCORE与logisticEuroSCORE的曲线下面积分别为0.606和0.598,汉族患者分别为0.574和0.553,维吾尔族患者分别为0.609和0.610。结论 EuroSCORE模型对本地区维吾尔族与汉族瓣膜病患者的死亡风险预测准确性较差,不适合心脏瓣膜手术的风险预测,临床应用时需谨慎考虑。
文摘欧洲心脏手术风险评估系统(European system for cardiac operative risk evaluation,EuroSCORE)是应用广泛并具有影响力的心脏外科风险评估系统之一。最初用于预测心脏手术后死亡概率的量化评分,之后应用范围发展到预测中长期死亡率和生存率、术后ICU滞留时间、治疗费用和重要并发症等方面。EuroSCOREⅡ是最新版本,其在预测手术死亡率、术后长期生存率等方面比旧版本更加准确,但也存在预测终点范围有限、低估重危患者死亡率、术前危险因素不够全面等不足。本文简述EuroSCORE的产生、发展以及临床应用情况。
